What’s a Summary of Benefits and Coverage?
Maybe you’ve heard the term, Summary of Benefits and Coverage — also called “SBC.” It’s often talked about when it comes to choosing health plans and learning about costs. That’s because it’s basically a document that outlines what’s covered — and not covered — under a health plan.
All health plan companies are required to provide an SBC for each of their different plans. When you’re making decisions about buying a plan or using your benefits, an SBC can be a useful tool to help you compare costs and understand coverage options.
For fully insured plans, the insurer is responsible for providing the SBC to the plan administrator (usually this is the employer). The plan administrator and the insurer are both responsible for providing the SBC to participants, although only one of them actually has to do this.
In addition to the SBC, make sure you have a provider directory.